Hale P C, Houghton A, Taylor P R, Mason R C, Owen W J, Bonell C, McColl L
Department of General Surgery, Guy's Hospital, London, UK.
J R Coll Surg Edinb. 1995 Feb;40(1):55-8.
The objective of this study was to compare an on call rota and partial shift working pattern for house surgeons in two hospitals. The study was conducted using a crossover trial of working both systems for 6 weeks each in two groups of newly appointed house surgeons. Assessment was by questionnaire to house surgeons, consultants, registrars, nursing staff and patients. The study took place at the departments of general surgery at Guy's and Lewisham Hospitals, London. A total of 12 house surgeons attached to four surgical firms and their consultants and registrars were the subject of our study. In addition the permanent nursing staff on designated general surgical wards and those patients of greater than 48 h stay on those wards on the day of assessment took part. Expectations of reduced fatigue levels using the partial shift system were not fulfilled. In contrast, this working pattern led to perceived disruption of the running of the surgical firms and demoralization of the house surgeons. Standards of patient care were, however, equally high using a rota or partial shift system. This comparison of a partial shift working pattern to an on call rota of similar average weekly hours demonstrated a marked preference for an on call rota from both medical and nursing staff although patients found both systems acceptable.
本研究的目的是比较两家医院住院医师的随叫随到排班制和部分轮班工作模式。该研究采用交叉试验，两组新任命的住院医师分别对两种工作系统各使用6周。通过向住院医师、顾问医生、住院医生、护理人员和患者发放问卷进行评估。研究在伦敦盖伊医院和刘易舍姆医院的普通外科进行。共有12名隶属于四个外科团队的住院医师及其顾问医生和住院医生参与了我们的研究。此外，指定普通外科病房的固定护理人员以及评估当天在这些病房住院超过48小时的患者也参与其中。使用部分轮班制来降低疲劳程度的期望并未实现。相反，这种工作模式导致了外科团队运营的混乱以及住院医师的士气低落。然而，使用排班制或部分轮班制时，患者护理标准同样很高。这种将部分轮班工作模式与平均每周工作时长相似的随叫随到排班制进行的比较表明，医护人员明显更倾向于随叫随到排班制，尽管患者认为两种系统都可以接受。
